Reducing Opioid and Other Drug Use in Justice-Involved Emerging Adults using Paraprofessional Coaches (with and without Lived Experience) to Deliver Effective Services in a Non-Treatment Setting

项目摘要/摘要 这个以患者为导向的导师研究职业发展奖(K23)的最终目标是发展 申请者成为一名独立的调查员，准备领导有道德的、大规模的、严格设计的 卫生服务研究的重点是高危新兴成年人(EAs；年龄在18-25岁)。具体地说，申请人将 重点改善使用阿片类药物和其他药物的环境评估机构获得和参与循证实践(EBP)的机会 药物使用(SU)和共生司法系统(JS)的参与，通过使用准专业教练。这个 拟议的职业发展和研究计划建立在申请者先前的临床和研究培训基础上 发展心理学、EBPS和SU。通过建议的培训计划，申请者将：(1)直接获得 在弱势人群中进行伦理健康服务研究的经验；(2)获得知识和 使用阿片类药物和阿片类药物的环境影响区关键发展成果的测量、方法和相互作用的技能 其他SU问题；(3)保健服务所需的复杂统计方法方面的高级专业知识 研究，包括混合方法研究，以及(4)促进作为独立的专业发展 卫生服务研究人员通过广泛的赠款培训，专注于具有阿片类药物和其他SU问题的EAs 撰写、拨款管理和开发健康服务研究计划。培训活动将 包括来自SU、随机临床试验、EA等领域专家团队的正式培训和指导 同行支持、生物伦理、司法、执行和高级卫生服务统计方法；密集 对高危人群进行道德研究的培训；关于实施的课程作业和讲座 科学、定性研究方法、统计和保护人类受试者；参与科学研究 研讨会和会议。申请者将把这些技能应用于旨在使用 准专业教练，以增加参与度和获得EBP(即，SU的应急管理 以及职业/教育指导)，为有SU和JS参与的EAS提供服务。与假释和 试用期，有SU的EA将被随机分配到有或没有LIFE的准专业教练那里工作 经验(即成功的SU恢复)。尽管使用同行准专业教练(那些有Live的教练 经验)在联邦一级变得越来越受欢迎和支持，这项工作的结果是 准职业教练本身，特别是针对EAS的教练本身，在很大程度上是未被探索的。拟议的研究将使用 定量和定性方法，以更好地了解对教练员和 他们的EA客户使用实施研究综合框架(CFIR)。考虑到高利率 特别是SU对有JS参与的EAS的不利影响，本项目的目标具有潜在的 以解决一个重要且代价高昂的公共卫生问题。作为苏和低职业/教育水平 大大增加再次犯罪的可能性，创新策略以减少阿片类药物和其他SU对于EAs是 关键，以及了解对服务提供商(即准专业教练)的影响。

PROJECT SUMMARY/ABSTRACT The ultimate goal of this Mentored Patient-Oriented Research Career Development Award (K23) is to develop the applicant into an independent investigator prepared to lead ethical, large-scale, and rigorously designed health services research focused on high-risk emerging adults (EAs; aged 18-25). Specifically, the applicant will focus on improving access to and engagement in evidence-based practices (EBPs) for EAs with opioid and other substance use (SU) and co-occurring justice system (JS) involvement, via use of paraprofessional coaches. The proposed career development and research plan builds on the applicant's prior training in clinical and developmental psychology, EBPs, and SU. Through the proposed training plan, the applicant will: (1) gain direct experience conducting ethical health services research with vulnerable populations; (2) attain knowledge and skills for measurement, methodologies, and the interplay of key developmental outcomes in EAs with opioid and other SU problems; (3) advance expertise in the complex statistical methods required for health services research, including mixed methods research, and (4) facilitate professional development as an independent health services researcher focused on EAs with opioid and other SU problems via extensive training in grant writing, grants management, and development of a health services program of research. Training activities will include formal training and mentorship from a team of experts in the fields of SU, randomized clinical trials, EA peer support, bioethics, justice, implementation, and advanced health services statistical methods; intensive training in conducting ethical research with high-risk populations; coursework and lectures on implementation science, qualitative research methods, statistics, and protection of human subjects; and participation in scientific workshops and conferences. The applicant will apply these skills to pilot research aimed at using paraprofessional coaches to increase engagement and access to EBPs (i.e., contingency management for SU and vocational/educational coaching) for EAs with SU and JS involvement. In partnership with parole and probation, EAs with SU will be randomized to work with paraprofessional coaches either with or without lived experience (i.e., successful SU recovery). Although using peer paraprofessional coaches (those with lived experience) is becoming more popular and supported at the federal level, the outcome of this work on the paraprofessional coaches themselves, especially for EAs, is largely unexplored. The proposed study will use both quantitative and qualitative methods to gain a better understanding of the impacts on both the coaches and their EA clients using the Consolidated Framework for Implementation Research (CFIR). Given the high rates and particularly detrimental effects of SU for EAs with JS involvement, the goals of this project have the potential to address an important and costly public health problem. As SU and poor vocational/educational attainment greatly increases the likelihood of recidivism, innovative strategies to reduce opioid and other SU for EAs is critical, along with understanding the effects on the service providers (i.e., paraprofessional coaches).